Anterior-to-Posterior Ankle Joint Mobilizations Improve Dynamic Postural Control in Chronic Ankle Instability Patients: A Critically Appraised Topic

Clinical Scenario: Balance impairment is common in patients with chronic ankle instability (CAI), especially during dynamic tasks. Manual therapies, such as ankle joint mobilizations are known to improve clinician-oriented outcomes such as dorsiflexion range of motion, but their impact on sensorimotor outcomes such as dynamic postural control and the retention of benefits remains less clear. Focused Clinical Question: Do anterior-to-posterior ankle joint mobilizations improve dynamic postural control in patients with CAI relative to a control condition and are those benefits retained after termination of the treatment? Summary of Key Findings: Three studies quantified the immediate effect and two studies quantified the retained benefit of anterior-to-posterior ankle joint mobilizations on improving Star Excursion Balance Test (SEBT) reach distances. Two studies demonstrated large immediate improvements in SEBT reach distances and those same investigations found that those large improvements were retained. Clinical Bottom Line: Ankle joint mobilization appears to improve SEBT reach distances and those improvements are retained. Strength of Recommendation: Strength of recommendation is a B due to inconsistent moderate-quality patient-oriented evidence.